HomeMy WebLinkAboutWORK ACCEPTANCE FORM CENTENNIAL PLUMBING - 21-00709 - Clair & Dees Point S Tires - RemodelContractor Work Acceptance Form
Business Name:*
Contact Name:*
Mailing Address
Email:*Phone:*
Mobile:
Discipline:*License #:*Expiration Date:*Value of Work:
Permit Number:*
Project Name:*
Project Address:*
By signing, I acknowledge that I am the indicated contractor for the above mentioned Permit/Project.
Signature Date
Contractor/Subcontractor
Centennial plumbing
Jeremy
City
Rexburg
State / Province / Region
Id
Postal / Zip Code
83440
Country
Update new contact information that is not already on file with the City of Rexburg
Street Address
Address Line 2
P.O. Box 486
jfyfe.centennialplumbing@hotmail.com 2083178702
Plumbing 12504 8/31/2024 8,000.00$
Permit Information
Please enter in the following format: 00-00000
21-00709 Point s
117north 2nd east
Acceptance
Sign 11/18/2021